Vestibular Activation: Why Is It Critical to Treatment?

The vestibular system is the primary sensory system that supports all of the other sensory systems and provides the bridge between sensory processing and motor control. So, it is essential that we ensure that it is functioning optimally in all of our clients. Many life experiences, starting in utero, can disrupt or compromise vestibular development and function, including the following:

  • Movement deprivation: This is often due to the mother being placed on extended bed rest or issues that compromise fetal development and movement such as trauma, illness, genetics
  • Paucity of tummy time: This is likely related to the infant sleeping only on their back or sides, being propped primarily in upright position with baby equipment, and excessive upright carriage by care givers
  • Low muscle tone and/or other diagnostic issues: These tend to limit sensory and physical engagement with and exploration of the environment
  • Deprivation and/or trauma: Can contribute to paucity of a rich, safe, supportive, inviting sensory environment, which ignites one’s curiosity and compels body movement to explore with touch, smell, taste, listening, and seeing so as to further comprehend the vast, amazing surround
  • Neuromuscular conditions and/or visual or hearing impairments: These may compromise one’s movement exploration

Many internal conditions and life experiences can interfere with vestibular processing and related sensory integrative processing functions. If the vestibular system is not providing automatic, rapid informational support for optimal performance, some or all of the following behaviors may be observed:

  • Poor balance
  • Fear of going into a dark area
  • Fear of being moved (unexpectedly or even when told in advance)
  • Poor oculomotor control
  • Sound sensitivity
  • Lack of attention to or poor orientation to sound
  • Poor tolerance for observing motion
  • Gravitational insecurity
  • Obsession for spinning self or objects
  • Disorganization
  • Emotional lability

Clearly vestibular processing is essential to optimal performance. Thus, I believe that we as occupational therapists need to be extremely well informed and competent in providing exemplary, precise, specific activation of all five bilateral receptors of the vestibular system. Additionally, we need to fully understand its intimate, critical relationship with all of the other sensory systems, especially the auditory and visual systems.

-Mary Kawar, MS, OT/L


Learn more about the importance of vestibular activation in the Astronaut Training course.


4 Comments on: “Vestibular Activation: Why Is It Critical to Treatment?

  1. Mary, I have been a practicing OT since the mid 70s…did I really just admit to that?!
    I have only done pediatrics, starting out at the pediatric hospital here in DC. I spent the majority of my days on the pediatric acute and rehab floors including the NICU.
    The remainder of my day in out- patient care and what we called our Diagnostic Clinic (for preschool and school age developmental/learning/SI issues) and the NICU Follow Along Clinic.
    It was the best grounding experience I could have ever imagined.
    Over the years so much changed at quite a rapid pace. More moms back on career track, exploding technology, large-almost institutional- daycare, and probably-most importantly SIDS and the link to belly sleeping. Who knew allowing our infants to be on their bellies was verboten!? Parents were scared. Containers to keep our babies up from the floor became an industry. Plagiocephaly, torticolis, and helmets became the norm and thus another whole industry evolved.
    Referrals to OT and ST skyrocketed as well….kids just weren’t the same….sensory and motor and language and cognitionwere disconnected…by what?
    Of course, that other sense that is so invisible and mysterious but ESSENTIAL. The depth of the vestibular system dysfunction in our developing kids seems catastrophic yet is so entirely preventable.

  2. Pat Leach I love what you are saying. That should be converted to a parent handout and widely distributed. With vestibular play suggestions that follow “safety” guidelines of course…

    • Two points come to mind, Marcie!
      1. The American Academy of Pediatrics would be wise to review the Back to Sleep initiative so that parents do not fear tummy time activity when their infant is awake.
      2. There are tons of SAFE and fun ways to use gravity (vestibular input) that can be a part of infant and child activities throughout the day. Therapeutic levels or treatment to reboot the system is best done with a trained therapist in concert with a well trained and enlightened parent.

  3. I agree that more parental education is important. Many parents are reluctant to do tummy time because babies do not enjoy it and cry, parents do not want to see their infants upset plus it’s inconvenient and a hassle for some. As for the pros vs. cons, I think we can all agree that torticolis and plagiocephaly are certainly better alternatives to SIDS!

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